Southeast Woundcare Experts LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME29049 Issued in FL

Legal business name

SOUTHEAST WOUNDCARE EXPERTS LLC

Practice address

13520 SW 152ND St
Number 771834
Miami, FL 33177-0101

Phone

(305) 238-3990

Fax

(305) 254-6331

NPI assigned

Nov 11, 2014

Last updated

Mar 23, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William David Lucky Sr., M.D.NPI 1538168075

Title

Owner

Phone

(305) 238-3990

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William David Lucky Sr., MD

  • Specialist
  • Homestead, FL
  • NPI 1538168075
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1992101471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13520 SW 152ND ST",
            "address_2": "NUMBER 771834",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331770194",
            "telephone_number": "305-238-3990",
            "fax_number": "305-254-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13520 SW 152ND ST",
            "address_2": "NUMBER 771834",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331770101",
            "telephone_number": "305-238-3990",
            "fax_number": "305-254-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST WOUNDCARE EXPERTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "LUCKY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-238-3990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME29049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038136500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Medical Lab Inc
• Southeast Medical Supplies Center Inc
• Southeast Physician Associates 1, LLC.
• Southeast Physician Associates Inc
• Southeast Urgent Care Group, Inc.
• Southeastern Community Mental Health Center Inc
• Southeastern Dental Associates VI
• Southeastern Med-Service Specialists, Inc. (Med-Service Specialists, Inc.)
• Southeastrern Dental Assoc, VII, PA
• Southern Advances Inc

• Specialist in Miami, FL
• Providers in Miami, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.